Clinical Spectrum, Management Strategies, and Outcome of Snake Envenomation Cases Admitted to a Tertiary Care Hospital of North India: Need for a Paradigm Shift

hospital, with an emphasis on identifying gaps to support uniform treatment protocols. Materials a n d MethodsThis was a retrospective observational study design in which patients admitted with a history of snakebite to Dayanand Medical College and Hospital, Ludhiana, India were enrolled.The study duration was 1 year from January to December 2022.This tertiary care teaching hospital in Northern India is a large referral center for neighboring districts and states.After Ethics Committee approval, medical records of all admitted snakebite cases were reviewed and a standard proforma was filled.Data related to demographics, socioeconomic status, time introduction The World Health Organization (WHO) recognizes snakebite as a major neglected tropical disease.Globally, snakebite accounts for 81,000-1,38,000 deaths annually, with India alone contributing to nearly half of it. 1In 2019, snakebite caused approximately 63,400 deaths in India. 2 Beyond mortality, snakebite-related amputations and disabilities affect nearly 4,00,000 people annually. 3enomous snakebites often present with life-threatening complications such as shock, paralysis, hemorrhage, renal failure, and severe local tissue necrosis, requiring prompt medical attention. 4,5Snake envenomation-related deaths are preventable, and a target to reduce the number of deaths to less than half by 2030 was set by WHO in 2019. 6 Snakebites in rural areas often go unreported as victims seek treatment from local dispensaries, with only the sickest cases being referred to higher centers. 7,8The true scale of mortality and morbidity from snakebite is being recognized of late and needs stringent reporting.While significant progress has been made in understanding venom composition and improving antisnake venom (ASV) production, the management of snakebites at ground level remains inconsistent.Challenges include fear of ASV reactions, shortages at rural facilities, transport delays, lack of standardized treatment protocols, and prevalent myths regarding traditional treatments.Furthermore, India's polyvalent ASV neutralizes venom from only the "big four" species, leaving other medically important snakes uncovered.Given the paucity of data from tertiary centers, this study aimed to evaluate the epidemiological profile, clinical features, management, and outcomes of snakebite cases at our tertiary care 1-